HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McNicholas, W. T. Search for Related Content PubMed PubMed Citation Articles by McNicholas, W. T.

Diagnosis of Obstructive Sleep Apnea in Adults

¹ St. Vincent's University Hospital and UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland

Correspondence and requests for reprints should be addressed to Walter McNicholas, M.D., Respiratory Sleep Disorders Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. E-mail: walter.mcnicholas{at}ucd.ie

ABSTRACT

The diagnosis of obstructive sleep apnea syndrome (OSAS) requires the combined assessment of relevant clinical features and the objective demonstration of abnormal breathing during sleep, and current evidence indicates that attempts to base the diagnosis of the clinical syndrome on either aspect alone are unreliable. The present review discusses the clinical assessment of patients with suspected OSAS and also the potential added value of structured questionnaires and clinical prediction models that seek to improve the diagnostic value of clinical assessment from the formalized evaluation of selected clinical features. While the traditional "gold standard" for objective assessment is laboratory-based polysomnography, there is growing evidence that limited sleep studies focused on respiratory and cardiac variables are adequate in most cases, and are particularly suited to home-based assessment. The choice between home versus sleep laboratory studies should be decided by taking into account resource limitations and the clinical index of suspicion for OSAS. At present, patients with either a low or high clinical index of suspicion for OSAS appear most suited to home-based investigation, whereas those with intermediate levels of clinical suspicion, or who present with atypical clinical features, may best be assessed by full polysomnographic studies in the first instance.

Key Words: sleep apnea • diagnosis

This article has been cited by other articles:

				W. T. McNicholas Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea: Overlaps in Pathophysiology, Systemic Inflammation, and Cardiovascular Disease Am. J. Respir. Crit. Care Med., October 15, 2009; 180(8): 692 - 700. [Abstract] [Full Text] [PDF]